to home or nursing facility to try to reduce preventable readmissions...Recognizing the limitations in the choice of data variables available ...After six months 55 participants (38.7%) had had a total of 102 unpla... Patients with multiple recent readmissions may have a unique risk fac...

to home or nursing facility to try to reduce preventable readmissions but they need to know which patients to focus on to have the biggest impact. Studies like ours should give practitioners direction to non-clinical factors to identify."

Recognizing the limitations in the choice of data variables available in studies using administrative data, the second smaller study used detailed clinical assessments to examine a range of readmissions risk factors in a recognized high risk patient group, those with two or more recent admissions. Dr Alison Mudge FRACP and colleagues at the Royal Brisbane and Women's Hospital, Australia, undertook detailed assessment of 142 patients aged over 50 admitted between February 2006 and February 2007 who had two or more hospitalizations in the preceding six months, studying factors such as depression, nutritional status, and functional status as well as demographic and disease variables.

After six months, 55 participants (38.7%) had had a total of 102 unplanned admissions to the hospital. As the researchers expected, the strongest predictor of readmission was the presence of a chronic disease diagnosis, but alongside this, they found that BMI had a non-linear relationship with readmission, with a higher risk in those underweight and obese; 72% and 50% of each category respectively were readmitted compared to 27% of those with normal weight and 37% of those classed as overweight. Depressive symptoms were also associated with a higher risk of readmission (47% readmitted). Age, sex, number of previous admissions, and discharge support were not significantly influential.

"Patients with multiple recent readmissions may have a unique risk factor profile, and may be a group which may particularly benefit from complex interventions, but no previous study has specifically examined risk factors in this high risk group," said Mudge. "We sought to look specifically at health factors which we know are under-recognized '/>"/>

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